56. Endoscopic vein graft harvest for coronary artery bypass surgery: Single center experience in Saudi Arabia

Open saphenous vein technique is the standard of care in patients undergoing coronary artery surgery (CABG) worldwide and in Saudi Arabia. Endoscopic vein harvest (EVH) is an innovative technique that have been recommended by the international society of minimally invasive surgery. Our aim in the current study is to review our preliminary data about endoscopic vein harvest. Would endoscopic vein harvest decrease the incidence of leg wound infections? This is a retrospective study of a single tertiary care center of 94 consecutive patients who underwent CABG with EVH. Preoperative associated risk factors were assessed. Postoperative follow up includes leg wound infection and patient satisfaction with EVH by using a telephone and/or a paper questionnaire. We had 94 consecutive patients who underwent CABG with EVH between October 2014 and October 2015, mean age was 56.7 (33–77) years, 91.5% were male, mean euro score II was 2.47%. The most common presentation was NSTEMI (39.4%) followed by STEMI (26.6%), unstable angina (11.7%) and stable angina (5.3%). Our cohort had the following characteristics: 85.1% were diabetic, 84% were hypertensive, 46.8% had dyslipidemia, 2.1% had CVA, 7.4% had Carotid artery disease, 2.1% had Congestive heart failure, 4.3% had any renal disease and 4.3% had previous PCI. Most of our patients received 3 grafts (44.7%) followed by 4 grafts (42.6%) of which only one leg was used for EVH (94.1%). Leg wound infection occurred in one patient only and in this case EVH was converted to open technique. A written and/or telephone questionnaire resulted in a high patient-satisfaction with the cosmetic outcome of EVH as well as very low grade of leg wound pain. EVH is a very promising innovative technique in patient undergoing CABG. Our patients were highly satisfied with their leg wound cosmetic outcome. In this single center experience, in Saudi Arabia, EVH is a promising innovative technique for saphenous vein harvest. It is highly recommended that cardiac centers in Saudi Arabia embrace such less invasive technology